Prepregnancy Weight in Women with Type I Diabetes Mellitus: Effect on Pregnancy Outcomes.
Citation: American Journal of Perinatology. 33(13):1300-1305, 2016 NovPMID: 27487228Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Abortion, Spontaneous/ep [Epidemiology] | *Body Mass Index | *Delivery, Obstetric/sn [Statistics & Numerical Data] | *Diabetes Mellitus, Type 1 | *Pre-Eclampsia/ep [Epidemiology] | *Pregnancy in Diabetics | *Premature Birth/ep [Epidemiology] | Abruptio Placentae/th [Therapy] | Adult | Body Weight | Diabetes Mellitus, Type 1/bl [Blood] | Emergencies/ep [Epidemiology] | Female | Humans | Pregnancy | Pregnancy in Diabetics/bl [Blood] | Prospective Studies | Young AdultYear: 2016ISSN:- 0735-1631
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
---|---|---|---|---|---|---|
Journal Article | MedStar Authors Catalog | Article | 27487228 | Available | 27487228 |
<b>Objective</b> This study aims to evaluate the association between prepregnancy body mass index (BMI) and adverse pregnancy outcomes in women with type 1 diabetes mellitus (DM). <b>Methods</b> This is a secondary analysis of a cohort of 426 pregnancies in women with type 1 DM recruited before 20 weeks gestation. Women were categorized according to prepregnancy BMI: low BMI (< 20 kg/m<sup>2</sup>), normal BMI (20 to<25 kg/m<sup>2</sup>), and high BMI (> 25 kg/m<sup>2</sup>). The outcomes of interest were: spontaneous abortion (delivery<20 weeks gestation); preeclampsia; emergent delivery for maternal indications (hypertension or placental abruption); and preterm delivery (< 37 weeks gestation). Analyses included proportional hazards and multiple logistic regression models with covariates: age, age at diagnosis of type 1 DM, previous spontaneous abortion, microvascular disease (nephropathy or retinopathy), and glycohemoglobin A<sub>1</sub> concentrations. <b>Results</b> Low BMI was associated with preterm delivery. High BMI was associated with emergent delivery for maternal indications. Glycemic control as measured by glycohemoglobin A<sub>1</sub> was associated with increased risk of spontaneous abortion, attenuating the association with low prepregnancy weight. <b>Conclusion</b> Prepregnancy BMI is a risk factor to be considered when caring for women with type 1 DM, in particular for preterm delivery (low BMI) and emergent delivery for maternal indications (high BMI).
Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
English